Journal
BMJ OPEN
Volume 12, Issue 4, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2021-057494
Keywords
Change management; Health informatics; Telemedicine
Categories
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Telemonitoring is a method of monitoring a person's vital functions remotely using technology. However, implementing telemonitoring on a large scale is challenging. This scoping review identified the enablers and barriers for upscaling telemonitoring across different healthcare settings. The most frequently mentioned factors influencing upscaling are resources, access to electronic medical records, and frontline staff knowledge. Successful upscaling requires insight into critical success factors, the use of technology in usual care, early reimbursement planning, change management programs, and clear regulatory conditions and guidelines.
Introduction and objective Telemonitoring is a method to monitor a person's vital functions via their physiological data at distance, using technology. While pilot studies on the proposed benefits of telemonitoring show promising results, it appears challenging to implement telemonitoring on a larger scale. The aim of this scoping review is to identify the enablers and barriers for upscaling of telemonitoring across different settings and geographical boundaries in healthcare. Methods PubMed, Embase, Cinahl, Web of Science, ProQuest and IEEE databases were searched. Resulting outcomes were assessed by two independent reviewers. Studies were considered eligible if they focused on remote monitoring of patients' vital functions and data was transmitted digitally. Using scoping review methodology, selected studies were systematically assessed on their factors of influence on upscaling of telemonitoring. Results A total of 2298 titles and abstracts were screened, and 19 articles were included for final analysis. This analysis revealed 89 relevant factors of influence: 26 were reported as enabler, 18 were reported as barrier and 45 factors were reported being both. The actual utilisation of telemonitoring varied widely across studies. The most frequently mentioned factors of influence are: resources such as costs or reimbursement, access or interface with electronic medical record and knowledge of frontline staff. Conclusion Successful upscaling of telemonitoring requires insight into its critical success factors, especially at an overarching national level. To future-proof and facilitate upscaling of telemonitoring, it is recommended to use this type of technology in usual care and to find means for reimbursement early on. A wide programme on change management, nationally or regionally coordinated, is key. Clear regulatory conditions and professional guidelines may further facilitate widespread adoption and use of telemonitoring. Future research should focus on converting the 'enablers and barriers' as identified by this review into a guideline supporting further nationwide upscaling of telemonitoring.
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